Disease management programs

Aetna Specialty Pharmacy understands the special needs of patients who require specialty medications. 

What to expect

Our special treatment programs include:


Assessment

After you place the first order for your patients, a patient care coordinator (PCC) will contact them to verify key information  like their age, weight, therapy, dose, any allergies, and shipping address. The PCC will assess therapy support needs. We will determine if your patients needs more help understanding their condition or medication.

Education

We will send patients a welcome packet to explain our services. Depending on each patient's need, a nurse or pharmacist who specializes in these diseases will provide additional education.

Extra service at refill time - We will call patients one week before their refills are due to schedule their next delivery. And while we're on the phone, we'll also check how they are doing.

We'll ask patients to confirm:

• How they are doing with their therapy
• If they are still taking the same specialty drug
• If they are still taking the same dose
• If they are having any side effects
• If they need additional supplies
• Where they would like their next refill delivered.

If they need help, we'll put them in touch with a nurse or pharmacist. We may also reach out to you to talk about a patient's medication or dose.

Care plan

We monitor therapy usage. We make sure your patients always have the right medication and dose for their needs. If  they want additional support, we will contact them as often as they'd like.
For patients with medical approval for home health care, we can arrange for a home health care nurse to administer their therapy in the comfort of their home. And we'll keep in contact with you so you know how  they are doing between office visits.

For  patients who may need extra emotional support, we can even put them in touch with an Aetna Behavioral Health specialist.

Crohn's disease therapy

Patients who require therapy with Remicade® will be supported by a personal nurse care manager who specializes in this therapy. The nurse care manager is a registered nurse who will contact assigned patients regularly to check on them. This nurse will also perform proactive refill coordination for patients who need Remicade. For patients who require therapy with the injectable B-12, we can teach them how to self-inject.

Pulmonary disease therapy

Before your patients begin therapy, we will:

• Make sure that you have enrolled them in the Letairis™ Education and Access Program (LEAP), if they require Letairis.
• Make sure that you have enrolled them in the Tracleer® Access Program (TAP), if they require Tracleer.
• Answer any questions they may have about their oral therapy, whether they require Letairis, Tracleer or Revatio.
• Check that they meet the criteria to receive their prescribed medication.
• Handle any approvals that the prescribed therapy requires.
• Process insurance paperwork and coordinate benefits.
• Provide them with information regarding available financial assistance programs, if necessary.
• Work with you to coordinate the start of therapy.

If your patient requires treatment with Letairis or Tracleer, our nurses will talk to them about what to expect and confirm that:

• They are not pregnant
• Their liver function is normal
• Their blood work is up to date

Transplant therapy 

Transplant patients will be assigned a personal nurse care manager. This is a registered nurse who specializes in transplant therapies. Your patient will also be assigned an Aetna National Medical Excellence Program nurse case manager. The nurse case manager will keep in touch with your patient for at least six months to check how they are doing.

Aetna Transplant Life Management Program^SM
Through this program, your patients may receive a 90-day drug supply. We will check their benefits plan to make sure a 90-day supply is right for them. And new transplant recipients will receive a backpack starter kit.

The backpack starter kit includes:

• Blood pressure cuff
• Thermometer
• Pill crusher
• Pill cutter
• Pill box
• List of transplant medications and potential side effects
• The book "Living with a transplant"

Personal nurse care manager

Your transplant patients will be assigned an Aetna National Medical Excellence Program® nurse case manager. The nurse case manager will keep in touch with them for at least six months to check how they are doing.

Transplant patients will also be assigned a personal nurse care manager. This is a registered nurse who specializes in transplant therapies. He or she will contact your patients as often as they need.